Treatment Outcome after Fractionated Conformal Radiotherapy for Hepatocellular Carcinoma in Patients with Child-Pugh Classification B Korea (KROG 16-05)
- Authors
- Bae, Sun Hyun; Park, Hee Chul; Yoon, Won Sup; Yoon, Sang Min; Jung, In-Nye; Lee, Ik Jae; Kim, Jun Won; Seong, Jinsil; Kim, Tae Hyun; Nam, Taek-Keun; Choi, Youngmin; Lee, Sun Young; Jang, Hong Seok; Lee, Dong Soo; Kim, Jin Hee
- Issue Date
- 10월-2019
- Publisher
- KOREAN CANCER ASSOCIATION
- Keywords
- Child-Pugh B; Hepatocellular carcinoma; Hepatic toxicity; Radiotherapy
- Citation
- CANCER RESEARCH AND TREATMENT, v.51, no.4, pp.1589 - 1599
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- CANCER RESEARCH AND TREATMENT
- Volume
- 51
- Number
- 4
- Start Page
- 1589
- End Page
- 1599
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/62785
- DOI
- 10.4143/crt.2018.687
- ISSN
- 1598-2998
- Abstract
- Purpose There is limited data on radiotherapy (RT) for hepatocellular carcinoma (FCC) in patients with Child-Pugh classification B (CP-B). This study aimed to evaluate the treatment outcomes of fractionated conformal RT in HCC patients with CP-B. Materials and Methods We retrospectively reviewed the data of HCC patients with CP-B treated with RT between 2009 and 2014 at 13 institutions in Korea. HCC was diagnosed by the Korea guideline of 2009, and modem RT techniques were applied. Fraction size was <= 5 Gy and the biologically effective dose (BED) >= 40 Gy(10) (alpha/beta=10 Gy). A total of 184 patients were included in this study. Results Initial CP score was seven in 62.0% of patients, eight in 31.0%, and nine in 7.0%. Portal vein tumor thrombosis was present in 66.3% of patients. The BED ranged from 40.4 to 89.6 Gyio (median, 56.0 Gyio). After RT completion, 48.4% of patients underwent additional treatment. The median overall survival (OS) was 9.4 months. The local progression-free survival and OS rates at 1 year were 58.9% and 39.8%, respectively. In the multivariate analysis, non-classic radiation-induced liver disease (RILD) (p < 0.001) and additional treatment (p < 0.001) were the most significant prognostic factors of OS. Among 132 evaluable patients without progressive disease, 19.7% experienced non-classic RILD. Normal liver volume was the most predictive dosimetric parameter of non-classic RILD. Conclusion Fractionated conformal RT showed favorable OS with a moderate risk non-classic RILD. The individual radiotherapy for CP-B could be cautiously applied weighing the survival benefits and the RILD risks.
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